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Abuse-deterrent formulas and withdrawal drugs only address the side effects of addiction, not the core issue.

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“Broken incentives” are preventing drug companies from investing in a sustainable solution to America’s opioid problem, according to economists and industry experts interviewed by Bloomberg.

Instead, drugmakers are focusing their energies on treating the side effects of the opioid crisis—such as buprenorphine for withdrawal symptoms, naloxone for reversing overdose.

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There's little incentive for the drug companies to do much more than that, according to the Bloomberg report. Instead of pushing for new innovations in pain relief, "broken incentives" set by government health programs and insurance policies instead "encourage drugmakers to treat the symptoms of the opioid epidemic," with much less focus on the "root of the problem."

Some are ditching the business of pain relief altogether. “Companies got out of the pain business,” says Pratap Khedkar, a sales and marketing consultant who studies the pharmaceutical industry. “It’s not the hotbed of innovation.”

Other companies are trying their hand at developing a non-addictive painkiller for the millions of Americans who suffer from chronic pain.

Pfizer and Eli Lilly are working on a non-opioid painkiller for osteoarthritis and chronic low back pain, according to Bloomberg. Nektar Therapeutics, a company based in San Francisco, is trying to reduce the euphoric effect of traditional opioid painkillers.

But it’s not realistic to expect that these “abuse-deterrent” painkillers will eliminate the risk of addiction in one fell swoop. “Irrespective how you make it, there is going to be the risk of developing abuse and addiction,” says Stephen Delisi, a psychiatrist and addiction specialist from the Hazelden Betty Ford Foundation. “A person who is at risk for addiction is going to still be at risk to become addicted.”

We’ve already seen the unintended consequences of pushing abuse-deterrent formulas. As Bloomberg notes, when Purdue Pharma reformulated OxyContin in 2010 so it could not be easily snorted or injected, there was a “marked increase in U.S. heroin overdoses” as people turned to the illicit opioid to get the same high.

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Opana ER was also reformulated in 2012 to make it more difficult for people to crush or liquefy the painkiller so they could snort or inject it.

However, this not only failed to prevent abuse of the drug, but is said to have contributed to rising rates of IV drug use and the spread of infectious disease.

As The Fix reported in 2015, Opana’s abuse-deterrent reformulation “almost certainly pushed some of those who had been snorting the drug towards injection habits in Indiana.” The extremity of Scott County’s HIV and hepatitis C outbreak convinced then-Governor Mike Pence to allow needle exchange in light of the public health emergency unfolding among his drug-injecting constituents.

Opana’s manufacturer, Endo Pharmaceuticals, announced this past July that it would be pulling Opana ER from the market. This came weeks after the Food and Drug Administration (FDA) issued a statement requesting that Opana be discontinued or risk losing approval.

This SoCal rehab fosters a regimented but respectful recovery environment, where teens learn how to live sober through plenty of 12-step meetings and life-skills classes—not to mention "equine-assisted psychotherapy" and mixed martial arts.

Alumni of The Clearing praise the non-12 step approach which focuses on "self-counseling skills" and "learning how to love yourself" while you heal in a historic, fully restored farmhouse surrounded by the natural beauty of San Juan Island.

This laid-back Malibu beachfront rehab charts a holistic path to recovery, which suits the twenty- and thirtysomethings who come here—you just might have to clock a few extra miles on the sand to burn off Chef Monte’s hearty home-cooking.

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